Nurses Role in Medication Administration

  Last updated: Monday January 06, 2003

Much of nursing practice involves decisions about:

Implications for Nursing Practice


Nursing Implications

Nursing Implications


Medication orders

Types of med orders

Essential parts of med order

Routes of Administration

Medication Administration
5 "rights"

Safe medication administration

Administering any meds


Administering oral meds

Administering parenteral meds

Administering parenteral meds


IM Site Selection






Needleless Systems/Protected Needles

Measurement Systems



Volume and Weight Equivalents

Basic principles of math









Converting between systems of measurement


May need 2 steps

Drugs measured in Units


5,000U X 1ml = 20,000U

Give = 1 or .25 ml 4


100 x = 40

x = 0.4 ml

Drugs provided in powder form


Add for U/ml 18 ml 250,000 8 ml 500,000 3 ml 1,000,000

(sterile water,NaCl)

You want to give 500,000U per dose.



IV fluids

medications to be added

to continuous infusion

to intermittent infusion


as bolus dose

Calculating milliliters per hour

Calculating Drops per Minute

= 31.25 gtt/min

Round to 31 gtt/min

Common IV Drop Factors


Rx: Kefzol 1 g IVPB q 6 h

(Mix in 50 ml D5W. Infuse over 20 min.)

Drop factor is 20 gtt/ml

Kefzol supplied as 500mg/ml.

500 mg = 1g

1 ml x ml

500 mg = 1000 mg

1 ml x ml

500 x = 1000

x = ml






50 ml X 20 (drop factor) = 20 (time in minutes)

1000 = 20

Run at 50 gtts/min

Tips from Errickson & Todd

e.g. 60 mg = 90 mg (60mg:1tab::90mg:x tabs) 1 tab x tabs

Names of drugs



Classifications of Drugs

According to:

Kinds of Drug Actions

therapeutic should outweigh side effect

Kinds of Drug Actions

Adverse effects (FDA MEDWATCH)

Iatrogenic disease

(e.g. elderly)

anaphylactic reaction - sudden, life-threatening

Drug Interactions

Combined effect of 2 or more drugs alters effect of one or both:

Demerol and Phenergan

Drug Standards

To predict effect based on consistency,

uniform quality

Drug Laws

and Control Act (1970) (Controlled Substances Act)

narcotics, amphetamines, barbiturates, tranquilizer


State Nurse Practice Acts

Decimal Point Dangers

Variables Influencing Drug Actions

Variables Influencing Drug Actions

Variables Influencing Drug Actions


Variables Influencing Drug Actions

Variables Influencing Drug Actions

Z-track Injection Method

(change needle or wipe off)

Questions ?